• Khalid Bajunaid, Ashwag Alqurashi, Abdullah Alatar, Mohammad Alkutbi, Anas H Alzahrani, Abdulrahman J Sabbagh, Abdullah Alobaid, Abdulwahed Barnawi, Ahmed Abdulrahman Alferayan, Ahmed M Alkhani, Ali Bin Salamah, Bassem Yousef Sheikh, Fahad E Alotaibi, Faisal Alabbas, Faisal Farrash, Hosam M Al-Jehani, Husam Alhabib, Ibrahim Alnaami, Ikhlass Altweijri, Isam Khoja, Mahmoud Taha, Moajeb Alzahrani, Mohammed S Bafaquh, Mohammed Binmahfoodh, Mubarak Ali Algahtany, Sabah Al-Rashed, Syed Muhammad Raza, Sherif Elwatidy, Soha A Alomar, Wisam Al-Issawi, Yahya H Khormi, Ahmad Ammar, Amro Al-Habib, Saleh S Baeesa, and Abdulrazag Ajlan.
• Department of Surgery, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia; Department of Neurology and Neurosurgery, Montreal Neurological Institute and hospital, McGill University, Montreal, Quebec, Canada.
• World Neurosurg. 2020 Nov 1; 143: e179-e187.

ObjectiveQuantitative documentation of the effects of outbreaks, including the coronavirus disease 2019 (COVID-19) pandemic, is limited in neurosurgery. Our study aimed to evaluate the effects of the COVID-19 pandemic on neurosurgical practice and to determine whether surgical procedures are associated with increased morbidity and mortality.MethodsA multicenter case-control study was conducted, involving patients who underwent neurosurgical intervention in the Kingdom of Saudi Arabia during 2 periods: pre-COVID-19 and during the COVID-19 pandemic. The surgical intervention data evaluated included diagnostic category, case priority, complications, length of hospital stay, and 30-day mortality.ResultsA total of 850 procedures were included, 36% during COVID-19. The median number of procedures per day was significantly lower during the COVID-19 period (5.5 cases) than during the pre-COVID-19 period (12 cases; P < 0.0001). Complications, length of hospital stay, and 30-day mortality did not differ during the pandemic. In a multivariate analysis comparing both periods, case priority levels 1 (immediate) (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.24-2.67), 1 (1-24 h) (OR, 1.63; 95% CI, 1.10-2.41), and 4 (OR, 0.28; 95% CI, 0.19-0.42) showed significant differences.ConclusionsDuring the early phase of the COVID-19 pandemic, the overall number of neurosurgical procedures declined, but the load of emergency procedures remained the same, thus highlighting the need to allocate sufficient resources for emergencies. More importantly, performing neurosurgical procedures during the pandemic in regions with limited effects of the outbreak on the health care system was safe. Our findings may aid in developing guidelines for acute and long-term care during pandemics in surgical subspecialties.Copyright © 2020 Elsevier Inc. All rights reserved.

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